Guinea

MSF continued to respond to the Ebola epidemic in Guinea, supporting Ebola treatment centres (ETCs) and assisting with safe burials, health promotion, community surveillance and contact tracing.

A year into the outbreak, it was evident that new ways of fighting the disease were necessary, and MSF was involved in research studies to find them. These included a vaccine trial targeting frontline workers in the capital Conakry, and the towns of Forécariah and Coyah, and people who had been in contact with newly confirmed cases. MSF also started an infection study, looking at which bodily fluids are more at risk of transmitting the disease and for how long after recovery.

Between January and March, MSF set up a rapid-response mobile team that could travel to wherever new Ebola cases were reported, quickly analyse the needs and propose an adapted approach. This team was deployed twice, to Faranah and Kissidougou.

In April, the ETC in Guéckédou was closed and what was formerly a Ministry of Health transit centre (set up with the support of MSF) in Forécariah was converted into an ETC by the French Red Cross. MSF supported the transfer of patients and ongoing work to identify new cases and conduct outreach activities.

In July, MSF opened new ETCs in Nongo, an area of Conakry, and the city of Boké. The centre in Nongo had capacity for 72 beds, and activities were transferred to this new site from Donka hospital. The result was an improvement in treatment standards and a greater focus on innovative solutions in patient care, such as scanning patient files using a camera in order to transfer them from a high- to a low-risk area.

The end of the Ebola outbreak in Guinea was declared on 29 December[1]. Since it started in March 2014, there had been 3,804 reported cases and 2,536 confirmed deaths, of which 110 were health workers.

Adherence to HIV treatment

The Ebola epidemic had acute consequences for people living with HIV, who need uninterrupted, life-long care. Many patients abandoned their treatment because they feared going to health facilities and contracting Ebola. MSF addressed this issue and sought to mitigate the risk of infection by implementing a six-month refill strategy (R6M) between April and June 2014. This meant stable patients needed to come only twice a year to pick up their medicine. Thanks to this strategy, over 90 per cent of HIV patients under R6M were still under treatment by March 2015; other healthcare providers reported significantly lower adherence.

HIV prevalence in Guinea is relatively low, affecting 1.7 per cent of the population. However, at the moment only one in four people living with HIV is on antiretroviral treatment. MSF has been providing high-quality HIV care in Guinea since 2003; this has included implementing strategies like R6M, and ensuring viral load monitoring is available to patients (an important laboratory measure of HIV in the blood that can indicate treatment success or failure). MSF currently manages a mid-level facility in Matam where a few beds are available for simple cases, and provides mentoring and training to support six health centres where HIV care is offered alongside other basic health services. In total, MSF works with a fifth of all people under treatment for HIV in the country.